Incidental skin malignancies in teledermatology and in-person cohorts in the Veterans Affairs Health System

Keleshian, Vasken; Ortega‐Loayza, Alex G.; Tarkington, Phillip E.

doi:10.1016/j.jaad.2017.01.027

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Mobile teledermatology is the use of a smartphone to take and send images and information to a teleconsultant; mobile as an incidental part of the FTF examination. With reduced FTF appointments, there is a real risk of these lesions going unnoticed [62,63]. However, the reverse can also be true:…”

Section: Mobile Teledermatology and Teledermoscopymentioning

confidence: 99%

Recent trends in teledermatology and teledermoscopy

Lee¹,

Finnane²,

Soyer³

2018

Dermatol Pract Concept

100

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Recent studies continue to examine teledermatology for a wide variety of disorders (Table 1); teledermoscopy has been mostly studied for assessing melanocytic and keratinocytic lesions [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Accuracy and Interobserver ConcordanceMost studies show comparable diagnostic accuracy between teledermatology and face-to-face (FTF) care [55,64,66,71,72], although 3 earlier studies reviewed by Lee and English [71] found teledermatology either significantly superior [9] or inferior [73,74]. More specifically, Finnane et al [75] reviewed accuracy of diagnosis for skin cancer; most studies showed that FTF consultations were more accurate than teledermatology (67%-85% vs 51%-85%); however, some studies found teledermatology was more accurate.

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Section: Mobile Teledermatology and Teledermoscopymentioning

confidence: 99%

Recent trends in teledermatology and teledermoscopy

Lee¹,

Finnane²,

Soyer³

2018

Dermatol Pract Concept

100

View full text Add to dashboard Cite

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“…This equates to a 0.9% (2/223) incidental melanoma detection rate within the 2014 dataset. Teledermatology has been shown to detect incidental skin malignancy (all types) in up to 3.6% of patients 37 …”

Section: Discussionmentioning

confidence: 99%

“…Teledermatology has been shown to detect incidental skin malignancy (all types) in up to 3.6% of patients. 37 The major limitation of this study relates to completeness of data -there were 175 lesions out of 592 (30%) that were triaged by the VLC for excision/biopsy but were not excised within the study period. The reasons for nonexcision is often complex and this cohort will be investigated in a follow-up study.…”

Section: E36mentioning

confidence: 97%

Virtual lesion clinic – Evaluation of a teledermatology triage system for referrals for suspected melanoma

Teague¹,

Wang²,

Wen³

et al. 2021

Aust J Dermatology

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Introduction:The Virtual Lesion Clinic (VLC) of Waitemat a District Health Board (WDHB) improves melanoma assessment and treatment using teledermatology. The VLC is reserved for pigmented lesions referred as suspected melanoma from primary care but indeterminate at the initial triage.Objectives: To assess the efficacy of the VLC diagnosis of melanoma.Methods: A retrospective audit of suspected melanoma referrals (1 January 2012 to 31 December 2016) was conducted. Lesions were referred to the VLC if diagnostic uncertainty remained at the initial triage. VLC patients attended MoleMap imaging centres, a dermatologist reviewed history and images remotely and suggested a diagnosis and management plan. Post VLC provisional diagnosis of melanoma, all lesions subsequently excised were reviewed. A positive predictive value (PPV) was calculated using concordance between VLC diagnosis of melanoma and histopathological diagnosis of melanoma. Number needed to excise (NNE) for melanoma was derived, as well as an invasive to in-situ melanoma ratio (IM:MIS) and false negative rate (FNR). Results:The VLC received 1874 referrals for 3546 lesions during the 5-year study period. Six hundred and seventy-nine lesions were recommended excision/biopsy or specialist face-to-face assessment, and 504 lesions were subsequently excised. The PPV was 62%, NNE 1.62 and IM:MIS 0.76 for lesions suspected to be melanoma at VLC assessment. The VLC had a melanoma-specific FNR of 7%. Conclusions:The VLC is effective in early diagnosis of melanoma with a high positive predictive value, low number needed to excise and low false negative rate amongst lesions referred as suspected melanoma.

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“…[ 13 ] The positive face of TD comprises its easy reachability to patients in remote areas or in practices with long waiting lists. [ 14 ] It also increases the number of patients consulted, and patients approved for lesion removal/biopsy and other procedures can be directly referred to surgical day. [ 15 ] The traditional way of practicing medicine is non replaceable, but TD will surely help to manage populations that are getting more vulnerable and older.…”

Section: Discussionmentioning

confidence: 99%